Name*:

Address*:

Phone*:

Email Address*:

Birth Date*:

School & Grade*:

*How many hours each week do you want to volunteer?

Do you want to volunteer during the summer, school year or both?

Are you interested in long-term or short-term volunteer work?

[checkbox "Long-term" "Short-term"] How long?

Please check those days and times you are available to volunteer:

MondayMorningAfternoonEvening

TuesdayMorningAfternoonEvening

WednesdayMorningAfternoonEvening

ThursdayMorningAfternoonEvening

FridayMorningAfternoon

SaturdayMorningAfternoon

Tell us about yourself!

Have you volunteered/worked anywhere before?

YesNo

If yes, where?

Describe your favorite part of that experience:

Tell us why you are interested in volunteering with the Richmond Heights Memorial Library. For example, do you need volunteer hours for school?

What extra-curricular activities are you involved in?

What are your interests? Hobbies?

Emergency Contact Information

Name*:

Phone*:

Relationship*:

List three references, other than relatives or significant others, whom you have known at least one year:

Name:

Phone:

Address:

Name:

Phone:

Address:

Name:

Phone:

Address:

Consent given for volunteer's photographic image to be published in promotional materials of the Richmond Heights Memorial Library. This may include but is not limited to newsletters, advertisements, and the RHML social media pages and website. Please check one: YesNo

Have you ever been convicted of a felony?

YesNo

If yes, please elaborate on another paper, then attach to this page.

I certify that I have answered and will answer all questions to the best of my ability and that I have not and will not withhold any information that would unfavorably affect my application for a volunteer position. I understand that information contained on my application will be verified by the Richmond Heights Memorial Library and that misrepresentation or omissions may be cause for my immediate rejection as an applicant or my termination as a volunteer.

Your electronic signature:

Parent/Guardian's Signature (Required if you are not 18 years old):